Treatment of advanced atrioventricular block with beta-adrenergic blockadetherapy

A 26-year old woman, who experienced syncope associated with advanced AV bl ock, was referred for further evaluation. Electrophysiological study showed normal SA and AV node physiology. Syncope associated with advanced AV bloc k on the electrocardiogram was induced by head-up tilt test. Oral propranol ol therapy completely prevented the AV block and syncope induced by head-up tilt. The physician should be aware of advanced AV block associated with n eurocardiogenic syncope, especially before permanent pacemaker therapy is c onsidered. The head-up tilt test is a useful diagnostic tool for an etiolog y of paroxysmal AV block.